Huang Qiuju, Wei Xin, Lin Xia, Zheng Jing, Huang Haiyan
Department of Otolaryngology Head and Neck Surgery，Hainan People's Hospital，Haikou，570311，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Feb;34(2):135-139. doi: 10.13201/j.issn.1001-1781.2020.02.009.
The aim of this study is to investigate the effect of sublingual immunotherapy with Dermatophagoides Farinae on the expression of specific IgG4（sIgG4） in patients with allergic rhinitis （AR） in Hainan area. Seventy-two patients with dust-mite allergic rhinitis, all three generations of whom were local islanders in Hainan, were randomly divided into control group（36 cases） and SLIT group（36 cases）. sIgG4 and sIgE expression levels were detected before treatment, 6 months after treatment, 12 months after treatment, and 18 months after treatment. The patient's symptom score, medication score, VAS score and adverse reactions was also assessed. Finally, through statistical analysis of the relevant data collected at 4 time points in the two groups of patients, the efficacy, safety and changes of sIgG4 antibody expression level in patients with allergic rhinitis receiving sublingual specific immunotherapy in Hainan were observed. Symptoms scores, medication scores and VAS scores were significantly improved in the SLIT group after treatment compared with before treatment（<0.05）, and serum sIgG4 increased significantly（<0.01）, serum sIgE showed no significant change（>0.05）. In the control group, symptom scores, medication scores and VAS scores were also significantly improved compared with before treatment（<0.05）, while serum sIgG4 and sIgE showed no significant change（>0.05）. When comparing the two groups, Symptoms scores, medication scores and VAS scores of the SLIT group were significantly lower than those of the control group at 12 months and 18 months after treatment（<0.05）. sIgG4 expression levels in the SLIT group were significantly higher than those in the control group after 6, 12 and 18 months of treatment（<0.01）. There was no significant difference in sIgE expression level between the two groups（>0.05）. No severe systemic adverse reactions occurred in the two groups, and 3 patients showed mild adverse reactions in the SLIT group. Sublingual immunotherapy of Dermatophagoides Farinae was effective and could increase the expression of sIgG4 in patients with Dermatophagoides farinae AR, sIgG4 is expected to be an immunological marker for the objective evaluation of the clinical efficacy of Hapten.
本研究旨在探讨粉尘螨舌下免疫疗法对海南地区变应性鼻炎（AR）患者特异性IgG4（sIgG4）表达的影响。72例尘螨变应性鼻炎患者，其三代均为海南本地岛民，随机分为对照组（36例）和舌下免疫治疗组（SLIT组，36例）。在治疗前、治疗后6个月、治疗后12个月及治疗后18个月检测sIgG4和sIgE表达水平。同时评估患者的症状评分、用药评分、视觉模拟评分（VAS）及不良反应。最后，通过对两组患者4个时间点收集的相关数据进行统计分析，观察海南地区接受舌下特异性免疫治疗的变应性鼻炎患者的疗效、安全性及sIgG4抗体表达水平的变化。与治疗前相比，SLIT组治疗后症状评分、用药评分及VAS评分均显著改善（P<0.05），血清sIgG4显著升高（P<0.01），血清sIgE无显著变化（P>0.05）。对照组治疗后症状评分、用药评分及VAS评分也较治疗前显著改善（P<0.05），而血清sIgG4和sIgE无显著变化（P>0.05）。两组比较，治疗后12个月和18个月时，SLIT组的症状评分、用药评分及VAS评分均显著低于对照组（P<0.05）。治疗6、12和18个月后，SLIT组sIgG4表达水平显著高于对照组（P<0.01）。两组sIgE表达水平无显著差异（P>0.05）。两组均未发生严重的全身不良反应，SLIT组有3例患者出现轻度不良反应。粉尘螨舌下免疫疗法有效，可增加粉尘螨变应性鼻炎患者sIgG4的表达，sIgG4有望成为半抗原临床疗效客观评价的免疫学指标。
